When we know someone pregnant, don’t we all love to comment on their bump? I mean, I guess that protruding tummy is kind of hard to avoid and we feel obliged to talk about it. And depending on how the mum feels, how they receive those comments can vary. When I was pregnant, I received a lot of “small bump” comments. I didn’t really mind much, I was small and I’m sure they meant well. But occasionally, some “you look good” small bump comments, are followed by “you’ve got it easy” bump comments. Which raises certain questions within me such as.

How do you know my pregnancy with a low birth weight baby meant it was easy? How do you know there aren’t any complications. And surely, how do you know I will have a smooth or easier delivery than someone carrying a bigger baby? Maybe you’re just trying to make me feel better and more at ease, but have you wondered whether there is an underlying medical reason?

“Oh, you have such a cute bump!”

“OMG! You’re pregnant? Since when?”

“You don’t even look pregnant!”

“Your bump is so small, so petite.”

Quickly followed with:

“You’re lucky, you’re going to have a tiny baby to push out!”

“Tiny babies don’t mess with your body as much as big babies do.”

“You need to eat more, even if you don’t want to eat, you baby has to.”

“This is no time to be dieting.”

Low birth weight

In the UK, around 7% of babies are born with a low birth weight (under 2.5kg or 5.5lb). This could be due to premature births or restricted growth in the womb.

Checks and measurements are usually done by measuring your bump around 24 weeks or through ultrasound scans.

What causes low birth rates?

There are many reasons that could lead to a baby having a low birth rate and could include:

• family history and ethnicity
• Chromosomal abnormality
• Infection during pregnancy
• Nutrients and oxygen not flowing to your baby properly in your placenta due to medical conditions such as pre-eclampsia or if you suffer an anautoimmune condition such as lupus.
• Low PAPP-A (Pregnancy-associated plasma protein A) level
• Substance abuse
• expectant mother’s weight, anaemia
• mental or emotional problems

My case

I come from a family with small babies, I, myself was born under 5lbs, so it’s not unusual that my babies will be small as well. With #JasperBean, he was born with a low birth weight. Weighing at 2.5kg/5.5lb at birth even though he was born almost full term at 37+5weeks. With my second pregnancy, I went through a similar experience with lots of hospital visits, consultants, midwife visits and scans. During one of the routine visits, it had been brought to my attention that apart from having a family history of small babies. I also have a low PAPP-A level. In total, I had 15 hospital scans while I was pregnant, where the usual is  around 2-4. It’s been a busy busy 9 months, although tiring, this has kept me reassured that everything was going in the right direction. At my 35th week scan they found that babys’ growth had dipped and booked me for more scans to measure the pattern. Luckily, at 36 weeks, the growth picked up a bit. However, at 39 weeks, they noticed that the fetal movement had reduced, so booked me for an induction on my due date (also due to my low PAPP-A level).

What is PAPP-A?

Pregnancy-associated plasma protein A is a hormone that is produced by the placenta during pregnancy. In the UK, this hormone is measured around the 13 week dating scan. A low level of PAPP-A has been suggested as a biochemical marker for babies born with an increased risk of Down’s Syndrome.

My results came back showing that I was low risk for Down’s Syndrome, however, my PAPP-A levels were still low enough to raise concerns with my midwife and the health authority. In your blood test results, there will be a MoM value for PAPP-A, 1.00 is the average, and recommended additional screening is advised for anyone measuring below 0.40. I was 0.2

How can PAPP-A affect my unborn baby?

Apart from predicting the chances of a higher risk of Down’s Syndrome. A low PAPP-A level is also associated with smaller babies due to placenta issues. Complications during pregnancy and birth could result in:

• intrauterine growth restrictions
• pre-eclampsia
• placental abruption
• fetus that is small for gestational age
• premature birth
• fetal death

What can I do if I have a low PAPP-A level?

Firstly, talk to your doctor/midwife if they haven’t contacted you yet! Secondly, don’t panic. From my second trimester, the doctors have advised that I get extra growth scans, roughly one every 2 weeks just to make sure everything is shaping out well. They usually offer it from 24 weeks onwards, but can change depending on your circumstances. This has definitely put my mind at ease knowing that someone is looking after me and my unborn baby. Reading horror pregnancy stories online does not help, but being edcuated and versed in it does.

And if you smoke, need I say more? STOP! This can seriously affect the oxygen level in your placenta, causing low birth weight among other issues.

Babies with low birthweight

A baby with a low birth rate may have increased risk complications. A tiny baby may not be as strong and can be more easily prone to infections and sudden infant death syndrome (SIDS). Having a small baby does not equal a smooth, easy delivery. Neither does it make it any less painful than someone who delivered a bigger baby. God only gives us what we can handle.

Never forget that God only gives you what he knows you can handle. There is no situation that you are experiencing alone. God walks beside you always.

The following charities, Bliss and Tommy’s, in the United Kingdom offer support to parents and parents-to-be with premature or babies likely to be born with a low birth weight. So don’t walk on this journey alone in the dark. If you seek, there is always help and guidance available.

Try not to worry!

Although some small babies may have a tough start. And you may worry yourself sick at the thought of your baby going through something horrendous before they even start their life in this world. I was very lucky that even though #JasperBean was born with a low birth weight. He has done me proud! He’s my teeny-tiny little itsy bean, but you know what? When compared with his peers now, yes, although he’s still scrawny (genetics). He has managed to catch up! And I don’t compare him to any growth chart, the kid down the road or the age range on store clothing labels.

I do still get the odd comment about whether I am feeding him properly. And I stress when he’s ill, more than I should. Because I know he’s going to lose those precious pounds that took me months to pile on. But it’s ok, I know what I’m doing is the best for him, thats what mothers do. I know one day, those comments will stop and people won’t give a damn.

Having a small baby has it’s trial and tribulations, but I wouldn’t have it any other way. So to all those on this journey, I wish you the very best for a healthy, energetic small baby!

Thank you for reading and until next time…

Love, MsMamaBean x

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References:

Breathnach FM, Malone FD (2007). “Screening for aneuploidy in first and second trimesters: is there an optimal paradigm?”. Curr. Opin. Obstet. Gynecol. 19 (2): 176–82.

Click to access low_papp-a.pdf